Abstract
The Health Services Center, Inc. (HSC) is a non-profit 501(c)3 community-based organization that has provided services for substance use disorders (SUD), co-occurring mental disorders (COD), family services, case management (CM), and HIV services in a low resource area of northeast Alabama for over 25 years. The proposed catchment area includes 14 predominantly rural/non-urban counties in the Alabama Department Public Health’s Eastern and Northeastern Public Health Districts. The service area has higher than state and national average experience of negative consequences related to SUD/COD, including overdose, drug and alcohol-related traffic fatalities, and DUI and other alcohol and drug-related arrests. Transitional aged youth in the service area are at increased risk for negative SUD/COD consequences and are more likely to be uninsured/underinsured, low income and to have reduced access to healthcare. HSC proposes Project REFRESH (Recovery, Education, Family, Reunification, Service, and Health) to address these issues. REFRESH will expand and enhance comprehensive SUD/COD treatment, early intervention services, and recovery supports for transitional youth (age 18 to 25) and their families/primary caregivers. The program will particularly target transitional aged youth from populations of color, LGBTQ+ populations, and low income/uninsured groups, as these populations are at increased risk for negative outcomes. The program will use targeted social media and community partnerships to market program services. In Phase I (weeks 1 to 12), HSC will provide evidence-based SUD/COD screenings and assessment targeting transitional aged youth (age 18 to 25; 500 screenings over the course of the project). Project REFRESH will then provide comprehensive outpatient SUD/COD services to 50 transitional aged youth in Year 1 and 100 annually in Years 2 through 5 (450 over the course of the project). Enrollees will receive the evidence-based, Adolescent Community Reinforcement Approach (A-CRA). A-CRA has strong research support with the target population, including increasing abstinence, decreasing COD symptoms, increasing long-term housing and employment stability. The model integrates caregivers/family as critical SUD/COD recovery supports. Phase II (weeks 13 to 24), will provide long-term, tailored SUD, COD, and CM aftercare services. Additional long-term (six months) recovery housing supports are proposed for a subset of a minimum of 10 of the enrollees annually. Finally, REFRESH will provide education and messaging on making healthy choices, including no use of any substances, through hosting 24 community educational and training events annually (120 over the course of the project). These community educational events (e.g., forums, health fairs, staff training) will highlight the specific challenges and needs of transitional aged youth populations and their families and will address stigma and discrimination associated with SUD/COD in underserved groups, including LGBTQ+ populations and communities of color. Anticipated outcomes include increased abstinence, decreased COD symptoms, increased housing and employment, and increased access to services.